Predictors of disease progression after endoscopic sinus surgery in patients with chronic rhinosinusitis

AbstractObjectiveThis study aimed to determine the predictors of disease progression after functional endoscopic sinus surgery in patients with chronic rhinosinusitis.MethodA total of 281 adult chronic rhinosinusitis patients who underwent primary bilateral functional endoscopic sinus surgery between 2007 and 2017 and had at least 12 months of follow-up endoscopic evaluation were examined. Patients were divided into eosinophilic (n= 205) and non-eosinophilic chronic rhinosinusitis groups (n= 76). In order to determine adverse factors, post-operative endoscopic appearance scores were analysed in relation to the pre- and intra-operative findings using multiple regression analyses.ResultsThe post-operative course of eosinophilic cases deteriorated over time, like the early period for non-eosinophilic cases. Frontal sinus polyps recurred early in eosinophilic chronic rhinosinusitis. Multivariate analyses indicated young adulthood, asthma, high computed tomography score and frontal sinus polyps as significant adverse predictors.ConclusionEarly, appropriate estimation of sinonasal conditions appears to be crucial for successful surgical management of chronic rhinosinusitis.

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Post-operative course prediction during endoscopic sinus surgery in patients with chronic rhinosinusitis

The Journal of Laryngology & Otology ◽

10.1017/s0022215118000543 ◽

2018 ◽

Vol 132 (5) ◽

pp. 408-417 ◽

Cited By ~ 3

Author(s):

K Tsuzuki ◽

K Hashimoto ◽

K Okazaki ◽

M Sakagami

Keyword(s):

Computed Tomography ◽

Chronic Rhinosinusitis ◽

Endoscopic Sinus Surgery ◽

Functional Endoscopic Sinus Surgery ◽

Recognition Threshold ◽

Sinus Surgery ◽

Endoscopic Appearance ◽

Eosinophilic Chronic Rhinosinusitis ◽

Superior Meatus ◽

Operative Findings

AbstractObjective:This study aimed to analyse findings of functional endoscopic sinus surgery to estimate the post-operative course of patients with chronic rhinosinusitis.Methods:From 2007 to 2015, 291 adult patients with bilateral chronic rhinosinusitis, divided into eosinophilic chronic rhinosinusitis (n= 210) and non-eosinophilic chronic rhinosinusitis (n= 81) groups, who underwent primary functional endoscopic sinus surgery were enrolled. Functional endoscopic sinus surgery findings, scored as operating score, were analysed in relation to pre-operative olfactory recognition threshold and sinonasal computed tomography imaging score, as well as post-operative endoscopic appearance.Results:Operating scores in eosinophilic chronic rhinosinusitis were significantly worse than those in non-eosinophilic chronic rhinosinusitis. The anterior ethmoid sinus and superior meatus were predominantly inflamed. Operating score significantly correlated with pre-operative olfaction recognition threshold, computed tomography score and pre-operative endoscopic appearance score. In eosinophilic chronic rhinosinusitis, higher operating scores were related to post-operative deterioration of endoscopic appearance score.Conclusion:The operating score reflects the course following functional endoscopic sinus surgery. Patients with more severe operative findings require longer post-operative treatment.

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Efficacy of Mitomycin-C for Prevention of Adhesion Formation after Functional Endoscopic Sinus Surgery in Cases of Chronic Rhinosinusitis: A Prospective Cross-sectional Study

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1207 ◽

2014 ◽

Vol 7 (3) ◽

pp. 100-104 ◽

Cited By ~ 1

Author(s):

Anilkumar Suryadev Harugop ◽

Ramesh Mudhol ◽

Amit Nargund ◽

Shailaja Hugar ◽

Amrit Kapoor ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Mitomycin C ◽

Endoscopic Sinus Surgery ◽

Adhesion Formation ◽

Cross Sectional Study ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Sectional Study ◽

Cross Sectional

ABSTRACT Objective To determine whether topical application of mitomycin- C at the conclusion of FESS decreases the incidence of postoperative adhesion formation. Study design Prospective cross-sectional study. Materials and methods Between June 2011 and June 2013, 42 patients (65 sides) aged between 16 and 66 years diagnosed to have chronic rhinosinusitis (CRS) underwent FESS. At the conclusion of the ESS, cotton ribbon wick soaked with 1 ml mitomycin-C (0.4 mg/ml) was placed in right/left/ both middle meati, near the widened sinus ostia for a period of 4 minutes. Following application, nasal cavity was irrigated with sterile normal saline. Patients were examined weekly for 1 month after surgery. Additional examinations were done at the end of 2nd and 3rd months postoperatively. At the end of 3 months follow-up, the outcome was assessed subjectively by symptoms and objectively by endoscopic findings. Results At the end of 3 months follow-up, a significant decrease (80%) in symptom scores was observed (6.64 ± 1.80, p < 0.001). Similarly in sinonasal outcome test (SNOT) score we observed a significant reduction (71%) in scores (17.76 ± 8.17, p < 0.001) and 3.1% cases showed adhesions. Conclusion CRS patients have remarkable improvement in their symptoms after FESS. Topical application of mitomycin-C at the conclusion of FESS/ESS has a role in prevention of adhesion formation. How to cite this article Harugop AS, Mudhol R, Nargund A, Hugar S, Kapoor A, Shetty R. Efficacy of Mitomycin-C for Prevention of Adhesion Formation after Functional Endoscopic Sinus Surgery in Cases of Chronic Rhinosinusitis: A Prospective Cross-sectional Study. Clin Rhinol An Int J 2014;7(3):100-104.

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Effectiveness of extensive sinus surgery with post-operative medical management for chronic rhinosinusitis

The Journal of Laryngology & Otology ◽

10.1017/s0022215116009361 ◽

2017 ◽

Vol 131 (S2) ◽

pp. S19-S24 ◽

Cited By ~ 1

Author(s):

A J Wood ◽

L Zhou ◽

S Wilkinson ◽

R G Douglas

Keyword(s):

Confidence Interval ◽

Medical Treatment ◽

Chronic Rhinosinusitis ◽

Symptom Score ◽

Endoscopic Sinus Surgery ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Symptom Improvement ◽

Patient Subgroups

AbstractObjective:To prospectively assess treatment outcomes of chronic rhinosinusitis patients undergoing functional endoscopic sinus surgery and post-operative medical treatment over a prolonged follow-up period.Methods:Patients undergoing functional endoscopic sinus surgery in the tertiary referral practice of a single surgeon were studied prospectively. Symptoms were scored by patients pre-operatively and over a minimum follow-up period of 12 months.Results:The study comprised 200 non-consecutive patients. The median pre-operative symptom score was 16 (out of a maximum of 25) (95 per cent confidence interval = 15 to 17). Symptom scores reduced to a median of 7 (95 per cent confidence interval = 6 to 8) after 12 months of follow up (p< 0.0001). The median symptom score improved for all symptoms and across all patient subgroups.Conclusion:Extensive functional endoscopic sinus surgery offers significant and durable symptom improvement in patients with chronic rhinosinusitis refractory to medical treatment. This improvement extends to all patient subgroups. Prolonged medical therapy is recommended after functional endoscopic sinus surgery.

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Double J stent of frontal sinus outflow tract in revision frontal sinus surgery

The Journal of Laryngology & Otology ◽

10.1017/s0022215112002745 ◽

2012 ◽

Vol 127 (1) ◽

pp. 43-47 ◽

Cited By ~ 1

Author(s):

H A K A Mansour

Keyword(s):

Endoscopic Sinus Surgery ◽

Frontal Sinus ◽

Outflow Tract ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Frontal Sinusitis ◽

Bilateral Disease ◽

Frontal Sinus Surgery ◽

Double J Stent

AbstractObjective:Frontal sinus surgery continues to challenge even the most experienced endoscopic sinus surgeon. Revision frontal sinus surgery is even more challenging. The use of stents in frontal sinus surgery has long been described, as an attempt to decrease the incidence of synechiae and stenosis.Method:This study included five patients who had previously undergone functional endoscopic sinus surgery but suffered recurrence of frontal sinusitis. Two had bilateral disease. Double J stents were used after endoscopic frontal sinusotomy. The stents were left in place for six months.Results:Four of the 5 patients (6 out of 7 sinuses) had a patent frontal outflow tract after 10 to 36 months’ follow up.Conclusion:Double J stents can be used as frontal sinus stents. They are well tolerated by patients, easily applied, and self-retaining with no need for sutures. The length of the stent can be altered according to the patient's anatomy and pathology.

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